Wake waphawula uketshezi olungavamile, olufana nobisi luvuza ngenxa yokulimala emzimbeni wakho, ngemva kokuhlinzwa, noma ngemva kwengozi enkulu? Noma ingabe lubangela ukuvuvukala kuleyo ndawo? Ungakhathazeki, lokhu kungaba yisimo esibizwa ngokuthi iChyle Leak, esizokhuluma ngaso namuhla. Lokhu kuyinto edinga ukunakwa, kodwa uma uyiqonda futhi uyiphatha kahle, ingelapheka. Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.

Kuyini iChyle Leak? Masiyiqonde kalula

Kulungile, ake siqale sibheke ukuthi lokhu kuvuza kwe-chyle kuyini. Umzimba wethu unesistimu ebizwa ngokuthi uhlelo lwe-lymphatic . Lokhu kufana nesistimu yemigwaqo emincane ngaphakathi emzimbeni wethu. Yilokhu okusiza amasosha omzimba wethu futhi kususe izinto ezingadingekile.

Manje, uma sidla, ikakhulukazi ukudla okunamafutha, kuyagaywa futhi kumuncwe amathumbu ethu. La mafutha amuncwayo kanye nezinye izakhamzimba zibizwa ngokuthi i-chyle , uketshezi olumhlophe olufana nobisi. Le chyle iyiswa nasezingxenyeni ezidingekayo zomzimba ngemithambo yethu ye-lymphatic.

Ngakho-ke, ngandlela thile, cabanga ukuthi uma le mithambo ye-lymphatic yonakele, kungaba ngesikhathi sokuhlinzwa noma engozini enkulu, uketshezi lwe-chyle luqala ukuvuza endaweni eyonakele. Yilapho uketshezi lwe-chyle luqoqana ezicutshini ezizungezile, okubangela izimpawu ezifana nokuvuvukala. Yilokhu esikubiza ngokuthi ukuvuza kwe-chyle , ngezinye izikhathi okubizwa ngokuthi ukuvuza kwe-chylous noma i-chylous fistula .

Lokhu kuvame ukuba umphumela ongavamile kodwa ongathi sína wokuhlinzwa. Odokotela bavame ukukwelapha ngokudla okukhethekile, ukuphumula, kanye nemithi uma kudingeka.

Kuvame kangakanani ukuvuza kwe-chyle?

Ukuvuza kukaKyle empeleni kuyisimo esingavamile kakhulu . Akwenzeki kuwo wonke umuntu. Kuvame kakhulu ngokuhlinzwa. Isibonelo:

• Lesi simo sibikwa ngaphansi kwe-1% yokuhlinzwa kokususwa kwe-thyroid.
• Kwezinye izinhlobo zokuhlinzwa kwekhanda nentamo, kungaba cishe yi-8%.

Futhi, lolu hlobo lokuvuza kwe-chyle lungenzeka ngemva kokuhlinzwa kwesisu, ukuhlinzwa kwesifuba, noma ukuhlinzwa kokususwa kwezinso (i-nephrectomy).

Kungakanani ukuvuza kwe-chyle?

I-Chyle Leak akuyona into okufanele ithathwe kalula, iyisimo esibucayi . Ngoba ingabangela izinkinga ezahlukahlukene emzimbeni wethu. Isibonelo:

• Ukuphelelwa amanzi emzimbeni: Inani lamanzi emzimbeni lingancipha.
• Ukungalingani kwama-electrolyte: Ibhalansi yama-electrolyte abalulekile emzimbeni ingaphazamiseka.
• Ukucindezela amasosha omzimba:Amandla okulwa nezifo angase anciphe.
• Ukudla okungenamsoco: Umzimba ungase ungatholi izakhamzimba ozidingayo.

Cabanga nje, okwenzeka kulokhu kufana noketshezi oluwusizo oluvela emzimbeni wethu oluphuma nje. Yingakho lokhu kungaba yinto engathi sína.

Akuvamile kakhulu, lesi simo singaba sibi kakhulu. Uma lokhu kwenzeka:

• I-Chylothorax: Lokhu ukuqongelela koketshezi lwe-chyle esikhaleni se-pleural, isikhala esiphakathi kwamaphaphu nodonga lwesifuba. Ngezinye izikhathi kuqala kutholakala njengesimo esibizwa ngokuthi i-pleural effusion.
• Ama-ascites e-Chylous: Lokhu kwenzeka lapho uketshezi lwe-chyle luqongelela emgodini wesisu. Ama-ascites yisimo lapho isisu sigcwala khona uketshezi.

Yini ebangela ukuvuza kwe-chyle?

Lesi simo sivame ukubangelwa ukulimala okubuhlungu esiswini, esifubeni, noma entanyeni . Kodwa-ke, ezimweni eziningi, imbangela eyinhloko ukulimala ngesikhathi sokuhlinzwa . Njengoba kushiwo ngaphambili, lokhu kuwumphumela ongavamile wokuhlinzwa. Le ngozi iphezulu kakhulu ekuhlinzweni kwekhanda nentamo. Lokhu kwenzeka ngenxa yokulimala kwemithambo ye-lymphatic, ikakhulukazi umthambo wethu oyinhloko we-lymphatic obizwa ngokuthi i-thoracic duct .

Ngezinye izikhathi, ukuvuza kwe-chyle nakho kungenzeka njengenkinga ye -lymphoma , umdlavuza wama-lymph node.

Iyini i-Thoracic Duct?

Umsele wesifuba, esikhulume ngawo, uyipayipi elikhulu kakhulu, elibaluleke kakhulu ohlelweni lwethu lwe-lymphatic. Ufana nomgwaqo omkhulu. Ugijima kusukela esiswini kuya entanyeni. Yipayipi elithwala i-lymph kanye ne-chyle ngezicubu zomzimba wethu. I-lymph evela engxenyeni engezansi kwesobunxele nakwesokudla yomzimba wethu ihamba ngaleli payipi. Ngakho-ke uma yonakala, kunethuba elikhulu lokuvuza.

Ziyini izimpawu zokuvuza kwe-chyle?

Ngesikhathi sokuhlinzwa, udokotela ohlinzayo angase akwazi ukubona i-chyle . Leso esinye sezibonakaliso. Futhi, ngemva kokuhlinzwa, lapho isiguli siqala ukudla, ikakhulukazi ukudla okunamafutha, odokotela bazobheka ukwanda koketshezi oluphuma emiseleni yokuhlinzwa.

Izimpawu ezingase zivele ngemva kokuhlinzwa yilezi:

• I-Lymphedema: Lokhu ukuvuvukala kwezindawo ezifana namalungu ngenxa yokuvaleka kwemithambo ye-lymph.
• Ukubomvu kwesikhumba: Isikhumba esizungeze ukuvuza singase sibe bomvu.
• Ukuvuvukala ngaphezu kwe-clavicle: Ukuvuvukala kungabonakala entanyeni, ngaphezu kwe-collarbone. Lokhu kuyimpawu ebonakala kakhulu uma umgudu wesifuba wonakele.

Ukubona kanjani ukuvuza kwe-chyle?

Ngesikhathi sokuhlinzwa, odokotela abahlinzayo bahlola indawo ukuthi ayinayo yini i-chyle ngaphambi kokuvala inxeba. Kodwa-ke, lokhu kuvuza akubonakali ngaso sonke isikhathi. Ngezinye izikhathi kuhlolwa kuphela ngemva kokuhlinzwa, lapho isiguli selulama.

Ukuhlolwa kokuxilonga

• Ngesikhathi sokuhlinzwa: Odokotela abahlinzayo ngezinye izikhathi baguqula umzimba wesiguli ube yizindawo ezithile bese befaka ingcindezi esifubeni noma esiswini ukuze bahlole ukuvuza kwe-chyle. Lokhu kwenziwa ngaphambi kokuvala inxeba.
• Ngemva kokuhlinzwa: Njengoba isiguli silulama, odokotela bazokwenza ukuhlolwa ngokomzimba ukuze bahlole izimpawu zokuvuza kwe-chyle. Bazohlola noketshezi oluvela emapayipini okuhlinzwa.
• Ukuhlolwa kwesampula yoketshezi: Uma kukhona ukuvuvukala, odokotela bazothatha isampula yoketshezi oluvela ekuvuvukeni bese beluhlola inani lamafutha, noma ama-triglyceride, kulo. Uma amazinga e-triglyceride oketshezini ephezulu kakhulu, kusho ukuthi i-chyle iyavuza.

Ilashwa kanjani i-chyle leak?

Kunezindlela eziningana zokwelapha, kuye ngokuthi ukuvuza kutholakale nini nokuthi kukhulu kangakanani.

Ukwelashwa ngesikhathi sokuhlinzwa

Uma kutholakala ukuvuza kwe-chyle ngesikhathi sokuhlinzwa, odokotela abahlinzayo bazozama ukuvimba ukuvuza ngokushesha okukhulu. Bazosebenzisa ama-clip noma ama-suture akhethekile ukuvala i-lymph duct eyonakele.

Ukunakekelwa ngemva kokuhlinzwa

Uma ukuvuza kutholakala ngemva kokuhlinzwa, ukwelashwa kuzoncika ngobukhulu bokuvuza (kungakhathaliseki ukuthi kuncane, kuphakathi, noma kukhulu) kanye nempilo yesiguli iyonke.

Ngokuvamile, ukwelashwa okungewona ukuhlinzwa kuyazanywa kuqala. Lokhu kubizwa ngokuthi ukwelashwa okulondolozayo . Ukuhlinzwa kuzocatshangelwa futhi kuphela uma lokhu kwehluleka ukulawula ukuvuza.

Ukwelashwa okungekona ukuhlinzwa

Ukuze umise ukuvuza kwe-chyle, udokotela wakho angase ancome okulandelayo:

• Ukuphumula Embhedeni: Ungatshelwa ukuthi uyeke ngokuphelele umsebenzi womzimba bese uphumula. Lokhu kuzonciphisa ukucindezeleka ohlelweni lwe-lymphatic.
• Ukudla okushintshiwe: Lokhu kubaluleke kakhulu. Ake sixoxe ngalokhu ngemininingwane ethe xaxa.
• Imithi evimbela ukumuncwa kwamafutha: Imithi inganikezwa enciphisa ukumuncwa kwamafutha emzimbeni ekudleni.
• Izithambisi zendle: Lezi zinikezwa ukuvimbela ukukhandleka ngesikhathi sokuhamba kwamathumbu, njengoba ukukhandleka kungandisa ingcindezi esiswini futhi kwandise ukuvuza.

Yikuphi ukudla okukhethekile komuntu onesifo sokuvuza kwesisu?

Lena yingxenye ebaluleke kakhulu yokwelashwa. Udokotela uzokutshelaUzokwaziswa ukuthi ulandele ukudla okunamafutha amancane noma okungenamafutha isikhashana. Kubalulekile ukulandela lokhu kudla njengoba kuqondiswe udokotela wakho kuze kube yilapho i-leek iphola.

Khumbula, i-chyle iwuketshezi oluqukethe amafutha kakhulu. Ngakho-ke uma sinciphisa amafutha ekudleni kwethu, inani le-chyle elikhiqizwayo nalo liyancipha. Lokhu kunciphisa inani lokuvuza, okunikeza uhlelo lwe-lymphatic ithuba lokuphulukiswa.

Ukudla okunamafutha aphansi kungafaka:

• Ezinye izinhlobo zezithelo (izithelo eziningi zinamafutha amancane).
• Isinkwa esingenamafutha, okusanhlamvu kwasekuseni, kanye nemikhiqizo yobisi engenamafutha.
• Inyama engenamafutha njengenkukhu nenhlanzi engenasikhumba.
• Imifino ebilisiwe ngaphandle kwamafutha.

Izinto okungafanele uzidle futhi ungaphuzi uma une-chyle leak

Udokotela wakho uzokutshela ukuthi ugweme ukudla neziphuzo ezinamafutha amaningi noshukela . Abanye abantu kungadingeka banikezwe uketshezi kanye nezakhamzimba ngendlela ye-IV (efakwa emthanjeni) ukuze bavimbele ukuphelelwa amanzi emzimbeni futhi banikeze ukudla okunempilo.

Yimiphi imithi yokwelapha i-chyle leak?

Udokotela wakho angase akunike imithi ethile yokwelapha ukuvuza kwe-chyle. Le mithi inikezwa nge-catheter efakwe emthanjeni (IV). Le mithi ihlanganisa:

• I-Somatostatin
• I-Octreotide

Le mithi isebenza ngokunciphisa ukukhiqizwa kwe-chyle kanye nokugeleza kwemithambo ye-lymphatic.

Ngezinye izikhathi, imithi yokwelapha ingasetshenziswa endaweni lapho kuvuza khona, kungaba ngesikhathi sokuhlinzwa noma ngemva kokuhlinzwa, ukusiza ukuvala ukuvuza.

Kuthatha isikhathi esingakanani ukululama ngemva kokwelashwa nge-Chyle Leak?

Ngokuvamile, ukuvuza okuncane kwe-chyle kungaphola zingakapheli isonto noma ngaphezulu , ikakhulukazi ngemva kokuba i-chyle isiphumile futhi ngokudla nokuzivocavoca okufanele. Kodwa-ke, okunye ukuvuza akupholi, futhi kungadinga ukuhlinzwa okwengeziwe ukuze kulungiswe.

Ingabe ukuvuza kwe-chyle kungavinjelwa?

Akukho lutho ongakwenza njengesiguli ukuvimbela ukuvuza kwe-chyle. Lokhu kungenxa yokuthi kwenzeka lapho imithambo ye-lymphatic yonakele. Kungenzeka ngesikhathi sokuhlinzwa noma engozini. Odokotela abahlinzayo bazama konke okusemandleni abo ukunciphisa lolu hlobo lomonakalo lapho benza ukuhlinzwa.

Yini ongayilindela uma unenkinga yokuvuza kwe-chyle?

Udokotela wakho uzokunikeza imiyalelo eningiliziwe yokuthi ungalawula kanjani ukudla kwakho nokunciphisa umsebenzi wakho womzimba . Kubaluleke kakhulu ukulandela le miyalelo ngqo. Futhi, qiniseka ukuthi uyawagcina ama-aphoyintimenti akho okulandelela.

"Uma ulandela imiyalelo kadokotela kahle, ungalulama kulesi simo ngokushesha. Ngakho-ke into ebaluleke kakhulu ukulalela lokho okushiwo udokotela."

Esikhathini esiningi, lesi simo siphela phakathi nesonto noma ngaphezulu ngokushintsha indlela yokuphila kanye nokudla.

Ingabe kukhona eminye imiphumela yokuvuza kwe-chyle?

Yebo, ukuvuza kwe-chyle kungalibazisa inqubo yokuphola kwenxeba emzimbeni wakho . Lokhu kungenxa yokuthi lapho i-chyle eyengeziwe inqwabelana ezicutshini eziseduze nenxeba, lezo zicubu zingavuvukala . Lokhu kuvuvukala kungalibazisa ukuphola kwenxeba futhi kwandise ingozi yokutheleleka.

Uyini umbono uma unesifo sokuvuza kwe-chyle?

Uma ukuvuza kwe-chyle kuphola kahle, ungabuyela ekudleni kwakho okuvamile . Futhi, inqubo yokuphola kwenxeba izokwenzeka ngokujwayelekile ngemva kokuba ukuvuza kuphole. Iningi lokuvuza kwe-chyle liyaphola cishe ngesonto ngokwelashwa.

Ingabe ukuvuza kwe-chyle kungenzeka izikhathi ezingaphezu kwesisodwa?

Yebo, nakuba kungavamile, kungenzeka ukuthi ukuvuza kwe-chyle kwenzeke izikhathi ezingaphezu kwesisodwa, ikakhulukazi uma umuntu oke wavuza ngaphambilini kufanele ahlinzwe futhi.

Ngingazinakekela kanjani uma nginokuvuza kwe-chyle?

Into ebaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo . Lokhu kuzokusiza ukwelapha ukuvuza kwe-chyle yakho ngokushesha futhi kuvimbele izinkinga. Ukudla, ukuphumula, kanye nokuphuza imithi yakho ngendlela efanele konke kubalulekile.

Isifinyezo: Izinto okufanele uzikhumbule

Ukuvuza kwe-Chyle kuyisimo esibi kakhulu esingase senzeke ngemva kokuhlinzwa noma ingozi ngenxa yomonakalo ohlelweni lwe-lymphatic. Kulesi simo, uketshezi oluqukethe amafutha olubizwa ngokuthi i-chyle luvuza ezicutshini zomzimba ezizungezile. Lokhu kungabangela izinkinga ezifana nokuphelelwa amanzi emzimbeni kanye nokuntuleka kokudla okunempilo.

Odokotela banikeza ukudla okukhethekile (okunamafutha amancane), ukuvinjelwa kokusebenza ngokomzimba (ukuphumula), kanye nemithi uma kudingeka. Ngokulandela imiyalelo kadokotela ngqo, lesi simo singelapheka esikhathini esingangesonto. Ngakho-ke, kubalulekile ukuqaphela lokhu nokulandela lokho okushiwo udokotela.

ukuvuza kwe - chyle, i-lymphatic duct, izinkinga zangemuva kokuhlinzwa, i-thoracic duct, i-chylothorax, ukudla okunamafutha aphansi